Nokea
What would be the first step for a nurse in efficiently addressing a situation of moral dilemma?
- A. Helping the client make a moral decision
- B. Recognizing one's own moral development level
- C. Abiding by the decision of the hospital authority
- D. Having one's own opinion that differs from the health care team
Correct Answer: B
Rationale: The correct first step for a nurse in efficiently addressing a moral dilemma is to recognize their own moral development level. By understanding their own moral reasoning, a nurse can effectively navigate moral challenges. Helping clients make moral decisions comes after the nurse has assessed their own moral standpoint. Abiding by hospital authority decisions may not always align with a nurse's ethical beliefs, so it's crucial for a nurse to form their own opinions and communicate concerns with the healthcare team to ensure ethical practice and decision-making.
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Which signs and symptoms would the nurse observe in a client with schizophrenia?
- A. Traumatic flashbacks and hypervigilance
- B. Depression and psychomotor retardation
- C. Loosened associations and hallucinations
- D. Ritualistic behavior and obsessive thinking
Correct Answer: C
Rationale: In clients with schizophrenia, the nurse would observe loosened associations and hallucinations. Loosened associations refer to disorganized thinking where thoughts are not logically connected. Hallucinations involve perceiving things that are not based in reality. Traumatic flashbacks and hypervigilance are more indicative of post-traumatic stress disorder. Depression and psychomotor retardation are common in depression, not schizophrenia. Ritualistic behavior and obsessive thinking are typically seen in obsessive-compulsive disorders, not schizophrenia.
Which behavior indicates that the client has learned the most effective method to cope with anger?
- A. Goes for a long jog
- B. Talks about the anger
- C. Goes outside and screams
- D. Focuses on cause of anger
Correct Answer: B
Rationale: The correct answer is 'Talks about the anger.' This response indicates that the client has learned a positive coping method, as discussing angry feelings is a healthier way of dealing with anger. Talking about anger allows for expression and communication, leading to a better understanding of the emotions involved. Going for a long jog or screaming outside may provide temporary relief, but they do not address the root cause or help in processing the emotions effectively. Focusing solely on the cause of anger without expressing feelings may lead to increased frustration and escalation of anger, rather than promoting constructive coping mechanisms.
Under what patient conditions or situations are restraints sometimes used?
- A. As punishment when the patient is uncontrollable
- B. To prevent the patient from pulling their IV out
- C. When a patient is a danger to self and others
- D. Both B and C
Correct Answer: D
Rationale: Restraints are sometimes used to prevent a patient from pulling out their IV or another life-saving tube and when the person poses a serious danger to themselves and/or others. Restraints are never used as a form of punishment. Choice A is incorrect because restraints are not utilized for punishment but for patient safety and care. Choice B and C are correct because they reflect the appropriate and necessary situations where restraints may be used in healthcare settings.
A client with untreatable metastasized cancer tells the nurse, 'I think they made a mistake. I don't think I have cancer. I feel too good to be dying.' Which stage of grief is the client experiencing?
- A. Anger
- B. Denial
- C. Bargaining
- D. Acceptance
Correct Answer: B
Rationale: The client is experiencing the stage of denial. This is evident as the client is having difficulty accepting the reality of their diagnosis and denies the presence of cancer despite the evidence. During the anger stage, the individual expresses anger about their situation, questioning why it is happening to them. Bargaining involves attempting to negotiate for more time or a different outcome, acknowledging the reality of death but trying to delay it. Acceptance, on the other hand, is characterized by coming to terms with the inevitability of death and preparing for it peacefully. Therefore, in this scenario, the client's disbelief and refusal to accept the diagnosis align with the denial stage of grief.
On her first visit to the neonatal intensive care unit to see her preterm newborn, the mother's only comment to the nurse is, 'My baby looks so fragile. Do you think my child will make it?' Which is the most appropriate response by the nurse?
- A. "Many infants born as small as yours have done just fine."
- B. "The staff is confident in your child's prognosis because preterm babies do look like this at first."
- C. "It's understandable that your baby looks fragile to you. What have you learned about the condition?"
- D. "Your baby is not as fragile as it appears. Do you find it so frightening that you can't touch your child?"
Correct Answer: C
Rationale: The nurse's response should aim to convey acceptance and encourage the mother to express her concerns. By saying, "It's understandable that your baby looks fragile to you. What have you learned about the condition?", the nurse acknowledges the mother's feelings and prompts her to share her understanding, fostering further communication and addressing any misconceptions. Choices A and B dismiss the mother's concerns by making general statements and do not encourage dialogue. Choice D implies judgment and may deter the mother from opening up about her fears.